Bad Blood?

Next time you need a blood transfusion, you might consider asking your doctor to check the expiration date. A new study has found that patients who receive "old blood" are significantly more likely to develop infections afterwards even if the blood is still good according to current standards.

Raquel Nahra and colleagues studied 422 patients who received transfusions while in intensive care at the Cooper University Hospital in Camden, N.J., between July 2003 and September 2006. Fifty-seven patients subsequently developed infections, such as pneumonia and upper respiratory and blood stream infections. The patients who received the oldest blood and the greatest number of units were most likely to develop at least one infection. Those who received blood stored for 29 days or more were twice as likely to get infections, with the oldest blood being associated with the most infections. Current federal regulatiorns allow red blood cells to be stored up to 42 days.

Many hospitals use the oldest available blood first to avoid waste. Previous research has found that the average age of transfused blood is around 17 days. In this study, the average age of blood was 26 days, and 70 percent of all the blood transfused was older than 21 days.

Stored red blood cells undergo changes that promote the release of substances called cytokines, which can depress the immune system and leave patients more susceptible to infection, the researchers say.Those changes start around 14 days of storage.

The findings were presented this week at a meeting of the American College of Chest Physicians in Philadelphia. James Mathers Jr., president of the college, says the findings raise questions about current blood storage standards and transfusion practices. But Mathers and the researchers say more research is needed to explore whether and exactly how those practices should be changed.

The first sentence in your article is misinformation. You want to ask your NURSE if the blood is old. I've never seen a doctor do anything with blood except write the order to transfuse. Two nurses check the blood type, expiration date, unit "serial number", and then verify the patient's name and birthdate with the patient, or the patient's wrist band if the patient is unable to speak. This is hospital policy, even in the hectic ER where I work. We do these checks in front of the patient,and I can't imagine a nurse getting seriously upset if a patient insists on knowing how old the blood is. This is YOUR body; know what is being given to you or being done to you.

The next time you need a blood transfusion, you may want to consider alternatives. Nonblood medical management, once reserved for those with a religious objection to taking blood, is gaining wider acceptance and reaping surprising results. It never hurts to ask what else is available.